AB1605 A PILOT RHEUMATOLOGY-INTERSTITIAL LUNG DISEASE (ILD) SERVICE - OUTCOMES AFTER 12 MONTHS
Authors: C. Riddell, J. Lindsay, E. Ball
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatologists have an important role in the management of interstitial lung disease (ILD). Cross-specialty collaborative working models are increasingly being used, particularly with ILD radiology MDT meetings, attended by respiratory physicians and rheumatologists, to discuss complex clinical cases. However, the infrastructure and format are not standardized) [1]. With the widespread financial and logistical pressures affecting delivery of healthcare in not only NHS setting, but worldwide; there is a need to provide robust evidence to managers and fundholders, of significant benefit to attract allocation of funding and resources towards MDT working in complex disease areas such as ILD. <h3>Objectives</h3> We describe the format and outcomes of a pilot rheumatology-ILD service at a large teaching hospital undertaken from January to December 2022. <h3>Methods</h3> Two rheumatology consultants (EB and CR) worked with the local ILD respiratory lead (JL) to plan for weekly attendance of one or both rheumatologists at a weekly ILD MDT. Prior to this, paper based referrals to general rheumatology were made if advice was felt to be required – generating paperwork, delays in the patient journey and an ad hoc approach across multiple rheumatology clinicians. This MDT is attended by respiratory clinicians, radiologists, ILD nurse specialist and respiratory trainees. Since the COVID-19 pandemic it has been conducted via Microsoft Teams and is scheduled for 1-1.5 hours weekly. Cases to be discussed are added in advance to MSTeam file on a specifically designed proforma. In addition there is a weekly ILD OPC attended by JL with a dedicated ILD nurse specialist. Rheumatology joined this clinic when other clinical commitments allowed which facilitated more focused discussion on management of complex cases. <h3>Results</h3> Over the course of a 12 month period rheumatology attended 24 ILD MDT meetings and 8 ILD out-patient clinics. This equated to approximately 80 hours of rheumatologist time over the pilot period. On analysis of cases presented, 33% required rheumatology input, most often on the basis of positive antibody screening or a prior history of rheumatological disease. The breakdown of rheumatology disease presented is detailed in Table 1 below. <h3>Conclusion</h3> There are a large number of ILD cases within the respiratory service that require rheumatology input – 33% of all ILD cases in this real-world snapshot. The spectrum of rheumatologically associated disease is vast. ILD can have a catastrophic outcomes and therefore early and continued rheumatology input is vital. Investment is needed for formal MDT infrastructure to include rheumatology. There is a need for data collection, collaborative working and research to improve the quality of care and outcomes for this population. <h3>Reference</h3> [1] Mehta et al. Rheumatologists have an important role in the management of interstitial lung disease (ILD): a cross-speciality, multi-centre, UK perspective. Rheumatology (Oxford). 2022 May 5;61(5):1748-1751 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.